"TRIPLE VERSUS QUADRUPLE INTENSIVE SHORT COURSE TREATMENT FOR NEWLY DIAGNOSED PTB: A META ANALYSIS." Charles Yu. CEU, De La Salle University, Cavite, Philippines.

Objectives: To evaluate the effectiveness of 3 versus 4 drug therapy in terms of: (1) relapse rate 1, 2 years, (2) AFB smear & culture conversions at 2 & 6 months, (3) radiologic improvement (2,6 months), (4) symptom relief, (5)compliance rate, (6) adverse reactions.
Data Sources: Systematic literature review was done using the search terms: treatment and or tuberculosis, tuber, clinical trials, randomized controlled trials. Databases searched included OVID-MEDLINE 1966 B Feb. 1998 HERDIN (Philippine) Database, search of international and Philippine abstracts, contact with primary authors and ancestry search.
Study Selection: (1) randomized control trial, (2) compared 3 versus 4 drugs in the intensive phase of treatment (3) involved adults > 15 years.
Data Collection and Analysis: 85 studies were reviewed from which 6 independent studies met the selection criteria, the trials has mean methodological quality score of 0.82 (range, 0.75 B 0.92).
Main Results: Of the 9outcomesanalyzed, 2 showed a definite trend for either 3 or 4 drugs. Four drug regimen showed a significantly more adverse reactions than 3 drugs at odds ratio 2.53% (CI, 1.42 to 4.53) while there was more compliance with the 4 drugs group with an odds ratio of 0.66 (0.45 to 0.98). All other outcomes showed no statistical difference.

Conclusions: A review of 6 RCTs on the triple versus quadruple drug therapy showed no difference in treatment outcomes except for adverse drug reactions at OR 2.53 (CI, 1.42 to 4.53 in favor of the 3 drug group) and more compliance in the 4 drug group, OR 0.66 (0.45 to 0.98) when streptomycin is used.